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Abstract:

Techniques for sutureless vascular anastomosis are described, including
an incision seal including a base configured to partially house an outer
surface of a main vessel, the base being formed using a material that is
configured to be penetrated by a barb disposed on a connector the main
vessel being secured to the base when the base is at least partially
pierced by the barb, an upper lumen configured to guide a graft vessel,
and a housing opening configured to receive the graft vessel.

Claims:

1. A deployment tool, comprising: a tip configured to house a connector,
the connector being configured to couple a graft vessel to a main vessel;
a locking mechanism configured to couple the deployment tool and an
introducer, the introducer being configured to be inserted into an
incision in a main vessel; a plunger configured to deploy the connector
from the tip; and a body configured to house the plunger.

2. The deployment tool of claim 1, wherein the connector is deployed from
the deployment tool when the plunger is depressed.

3. The deployment tool of claim 1, wherein the connector is pre-loaded
within the tip.

4. The deployment tool of claim 1, wherein the body comprises a hollow
chamber configured to receive the plunger.

5. The deployment tool of claim 1, wherein the plunger comprises a safety
pin configured to prevent deployment of the connector.

6. The deployment tool of claim 5, wherein the safety pin contacts an
edge of the body to prevent deployment of the connector.

7. The deployment tool of claim 1, further comprising a rod coupling the
connector and the plunger, the rod being configured to deploy the
connector from the tip when the plunger is depressed.

8. The deployment tool of claim 7, wherein the rod comprises a first end
substantially the same shape as an end of the plunger and a second end
substantially the same shape as an end of the connector.

9. The deployment tool of claim 1, wherein the locking mechanism is a
fitting of a male-female interconnect pair.

11. The deployment tool of claim 9, wherein another fitting of the
male-female interconnect pair is disposed on the introducer, wherein the
locking mechanism and the introducer are securely coupled when the
fitting and the another fitting are threaded together.

13. The deployment tool of claim 1, wherein the locking mechanism
includes an alignment mark.

14. The deployment tool of claim 13, wherein the introducer includes
another alignment mark, wherein the alignment mark aligns with the
another alignment mark when the introducer and the locking mechanism are
properly aligned.

15. The deployment tool of claim 13, wherein the introducer includes
another alignment mark, wherein the alignment mark aligns with the
another alignment mark when the introducer and the locking mechanism are
properly secured.

16. A method for deploying a connector, comprising: inserting a
deployment tool into an introducer, the introducer being partially
inserted inside a main vessel; coupling a fitting disposed on the
deployment tool with another fitting disposed on the introducer, the
fitting and the another fitting being configured to interlock with one
another; depressing a plunger of the deployment tool to deploy a
connector housed within the deployment tool inside the main vessel; and
removing the deployment tool and the introducer from the incision.

17. The method of claim 16, wherein inserting the deployment tool
comprises inserting a tip of the deployment tool into the introducer.

18. The method of claim 16, wherein coupling the fitting comprises
threading the fitting into the another fitting.

19. The method of claim 16, wherein depressing the plunger comprises:
removing a safety pin from the plunger; holding a handle of the
deployment tool; and applying pressure to the end of the plunger while
holding the handle.

20. A deployment tool, comprising: a connector configured to couple two
vessels; a deployment tip configured to house the connector; a locking
mechanism coupled to the deployment tip, the locking mechanism being
configured to couple the deployment tool to an introducer, the introducer
being configured to be inserted into an incision in a vessel; a body
coupled to the locking mechanism, the body comprising a hollow chamber
coupled to the deployment tip; a plunger configured to be housed in the
hollow chamber; and a rod coupling the plunger and the connector, wherein
the connector is deployed from the deployment tip when the plunger is
depressed.

[0002] The present invention relates generally to anastomosis, and more
specifically, to techniques for sutureless vascular anastomosis.

BACKGROUND OF THE INVENTION

[0003] Generally, anastomosis refers to the connection of blood vessels or
other structures that may be found in the human body. Conventional
solutions for vascular anastomosis typically refer to the use of devices
and surgical procedures in which one vessel is surgically joined to
another vessel. This procedure is required for a variety of medical
procedures, including procedures involving redirection of bodily fluids
such as blood within the patient. One conventional example is a cranial
bypass procedure that diverts a portion of the flow of a temporal artery
located outside of a skull to one or more arteries within the skull in
order to provide additional blood flow to a patient's brain.

[0004] When performing any form of vascular anastomosis, a major concern
is that the flow of bodily fluid must be interrupted for the duration of
the procedure. This interruption of flow, if too long, causes detrimental
effects to organs and surrounding tissue, which can endanger, jeopardize,
or worsen a patient's general health.

[0005] Currently, a common conventional method of vascular anastomosis
includes manually applying a number of sutures to create a
fluid-impermeable seal between two vessels. This process is not only
difficult, time consuming, and expensive, but also requires a high degree
of surgical skill and a considerable amount of time and patience from a
surgeon. Additionally, the use of sutures introduces a potential weakness
in a surgical connection placed to connect two or more vessels, often
resulting in tearing or leakage. Further, a surgeon is often required to
test a conventional anastomosis connection between two vessels to ensure
that the sutures have created a fluid impermeable seal. A leak resulting
from poor or weakened sutures can create a number of problems such as
internal hemorrhaging for the patient, requiring additional surgeries,
time, and expense. Also problematic are conventional connectors used in
anastomosis procedures that are often bulky, unwieldy, or difficult to
use, typically requiring significant skill and specialized equipment that
can be expensive to manufacture and purchase. Further, the time required
for submission, review, and governmental approval of applications for the
use of elaborate medical devices in humans for anastomosis applications
is substantial, incurring significant social and health care costs due to
the delay. Some conventional solutions used in applications such as
side-to-end vascular anastomosis often require more time, expertise, and
effort since joining an end of a vessel to a side of another vessel is
more time-consuming and skill-intensive than joining an end of a vessel
to an end of another vessel.

[0006] Thus, a solution for more vascular anastomosis without the
limitations of conventional techniques is desired.

BRIEF DESCRIPTION OF THE DRAWINGS

[0007] Various examples are disclosed in the following detailed
description and the accompanying drawings:

[0045] Embodiments or examples of the invention may be implemented in
numerous ways, including as an apparatus, system, or process. A detailed
description of one or more examples is provided below along with
accompanying figures. The detailed description is provided in connection
with such examples, but is not limited to any particular example. The
scope is limited by the claims, but numerous alternatives, modifications,
and equivalents are encompassed. Numerous specific details are set forth
in the following description in order to provide a thorough
understanding. These details are provided for the purpose of example and
the descriptions provided may be used for implementation according to the
claims without some or all of these specific details. For the purpose of
clarity, technical material that is known in the technical fields related
to the examples has not been described in detail to avoid unnecessarily
obscuring the description.

[0046] Various techniques and devices for sutureless vascular anastomosis
are described, including a connector and an incision seal system that may
be configured and used to join, seal, or otherwise couple a first vessel
to a second vessel without the use of sutures. In some examples, the
first vessel and second vessel pair may be a graft vessel and main vessel
pair, a donor vessel and recipient vessel pair, or any other pair of
vessels. As used herein, a graft vessel may be referred to as a "donor"
vessel, artery, vein, or the like. Also and as used herein, a main vessel
may be referred to as a "recipient" vessel, artery, or the like. These
terms may be used interchangeably without limitation. For example, the
graft vessel may be a superficial temporal artery (STA) and the main
vessel may be a mid cranial artery (MCA). In other examples, the graft
and main vessels may be other arteries, vessels, veins, or vascular
structures and are not limited to any specific types or structures.
Exemplary connectors may be configured to couple a graft vessel to a main
vessel to provide a lumen (i.e., a channel, passageway, artery, vein, or
the like) to transfer fluids (e.g., blood) between a graft vessel and a
main vessel. After an exemplary connector has coupled a graft vessel to a
main vessel, an exemplary incision seal may be engaged with the connector
to seal the graft vessel to the main vessel. In some examples, an
incision seal may be configured to lock, mate, or otherwise connect with
a connector. In some examples, the coupling of a connector with an
incision seal may create a clamping force that secures a portion of an
upper wall of the main vessel between the incision seal and the
connector. In other examples, the described systems may be varied in
design, function, structure, or implementation and are not limited to the
techniques described below.

[0047] FIG. 1 illustrates an exemplary sutureless vascular anastomosis
system. Here, system 100 includes graft vessel 110, main vessel 120,
connector 130, tines 132, front wing 134, rear wing 136, tines 135 and
137, side wing 139, barbs 138, and incision seal 140. In some examples,
connector 130 may be fabricated, manufactured, or otherwise formed using
various types of medical-grade material, including stainless steel,
plastic, composites of any type, and alloys such as nickel titanium,
Nitinol® (e.g., Nickel Titanium Naval Ordnance Laboratory) or super
elastic Nitinol®. For example, if Nitinol® is used, it may be
formed at various pressures and temperatures in order to provide for a
memory shape where front wing 134, rear wing 136, side wing 139, and
barbs 138 are deployed. As another example, super elastic Nitinol® may
be configured to behave similar to a spring when a restraining force is
removed. In yet other examples, materials may be used such that when
formed, a "material memory" is created in a given shape of connector 130.
In other words, connector 130 may be formed such that when a restraining
force is removed, a given shape is assumed. When placed into a restrained
shape and inserted into main vessel 120, the restraining force may be
removed to allow front wing 134 and rear wing 136 to deploy securely and
engage into the tissue of the upper wall of main vessel 120 using tines
135 and 137. As another example, alloys may be used to form connector 130
such that when placed into a fluid (e.g., blood) stream such as that
within main vessel 120, the heat of the surrounding fluid may cause
memory material used to form connector 130 to change shape (e.g., deploy
front wing 134 and rear wing 136). In other examples, connector 130 may
be formed differently and is not limited to the examples described.

[0048] Here, connector 130 may be configured to couple graft vessel 110 to
main vessel 120 in a sutureless manner. Once coupled, fluids may pass
between graft vessel 110 and main vessel 120. As an example, incision
seal 140 may be coupled to connector 130 to provide a leak-proof seal
between graft vessel 110 and main vessel 120.

[0049] As shown here, connector 130 may include tines 132, front wing 134,
and rear wing 136. These portions of connector 130 may be configured to
securely engage connector 130 with graft vessel 110 and main vessel 120.
For example, tines 132 may be configured to securely engage an inner
surface of graft vessel 110 while front wing 134 and rear wing 136 may be
configured to securely engage an inner surface of main vessel 120. Tines
132 may prevent the connector from being displaced with respect to the
graft vessel when the connector is coupled to the graft vessel. In some
examples, connector 130 may further include barb 138 for coupling
connector 130 with incision seal 140. Barb 138 may be configured to
puncture a portion of a wall of main vessel 120 and lock with incision
seal 140. For example, incision seal 140 may include a slot configured to
lock with barb 138. In another example, incision seal 140 may comprise of
a malleable material configured to receive and lock with barb 138. For
example, the incision seal may be formed of medical grade silicone.
Locking connector 130 with incision seal 140 may secure the juncture of
graft vessel 110 and main vessel 120 between connector 130 and incision
seal 140. This may allow graft vessel 110 to securely contact main vessel
120, thus creating a leak-free seal. Over time, graft vessel 110 and main
vessel 120 may graft with one another and form an integrated vessel. In
some examples, system 100 may replace barb 138 and the slot with other
fasteners. Other fasteners may include hooks, clamps, screws, cables, and
adhesives to name a few. It should be understood by those skilled in the
art that a "barb" may be replaced with a first part of a fastener and
that a "slot" may be replaced with a second part of a fastener in this
specification. In other examples, the shape and configuration of
connector 130, tine 132, front wing 134, rear wing 136, tines 135 and
137, barb 138, and incision seal 140 may be implemented differently and
are not limited to the examples shown and described. For example, the
wings, tines, or barbs may vary in number, shape, and placement.

[0050] In some examples, one or more portions of connector 130 may include
a memory material that causes the one or more portions to change shape.
As used herein, "memory material" may refer to any material that, when
formed, shaped, fabricated, poured, deposited, or otherwise implemented
has a material property that allows for a physical shape under a given
set of conditions (e.g., temperature, pressure, or the like) and assumes
a different physical shape when one or more conditions change. For
example, a memory material may cause a portion of connector 130 to assume
one shape when a restraining force is applied and then assume another
shape when the restraining force is removed. In another example, the
memory material may cause the portion to be spring loaded such that the
portion springs from a first position into a second position when a
restraining force is removed. As shown here, front wing 134 may include a
memory material that causes front wing 134 to align with an outer surface
of the end of connector 130 when a restraining force is applied. This
characteristic may allow connector 130 to maintain a cylindrical shape
when inserting into main vessel 120. Front wing 134 may also deploy or
swing away from the end of connector 130 when the restraining force is
removed. This characteristic may allow front wing 134 to deploy and
securely engage the inner surface of main vessel 120 after connector 130
has been inserted into main vessel 120. In other examples, the
above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0051] FIG. 2 illustrates a front view of an exemplary sutureless vascular
anastomosis connector. Here, connector 200 includes connector tip 210,
connector body 220, tines 222, and connector base 230. In an example,
connector tip 210, connector body 220, and connector base 230 may be
integrated with connector 200. For example, these parts of connector 200
may form a continuous tubular structure that may be configured to serve
as a lumen for fluid transfer between two ends of connector 200. In
another example, connector tip 210, connector body 220, and connector
base 230 may be separate structures that are coupled together to form
connector 200.

[0052] In some examples, an interior of connector 200 may serve as a lumen
for fluid transfer between a graft vessel coupled to one end of connector
200 and a main vessel coupled to another end of connector 200. The rate
of fluid transfer through connector 200 may depend upon the
cross-sectional area of connector 200. In other examples, connector 200
may be made of a memory material. The memory material may provide
flexibility to connector 200. For example, this flexibility may allow
connector 200 to slightly flex when forces are applied to connector 200.
The forces may be an external force applied to an external surface of
connector 200 or an internal force applied to an internal surface of
connector 200. Alternatively, the flexibility may provide functionality
to connector 200. For example, the memory material may allow portions of
connector 200 to change shape or position. The changes in shape or
position may assist in securing a graft vessel to a main vessel.

[0053] As shown here, connector base 230 may be disposed at an end of
connector 200. In some examples, connector base 230 may be configured to
securely engage a main vessel. For example, connector base 230 may be
configured to securely engage a main vessel through an incision in a wall
of the main vessel. This may include inserting connector base 230 into
the main vessel and securely engaging connector base 230 with an inner
wall of the main vessel. Connector base 230 may include front wing 232.
In some examples, front wing 232 may be composed of a memory material
that causes front wing 232 to change shape or position based upon
external forces. For example, front wing 232 may be configured to be
substantially planar (or aligned) with an outer surface of connector 200
when a restraining force is applied to front wing 232. The restraining
force may be caused by elastic bands, sheaths, wrappers, or other
physical elements. Alternatively, the restraining force may be caused by
the temperature or chemical attributes of the environment surrounding
connector 200. For example, the temperature of connector 200 may affect
the restraining force or the chemical composition of a fluid coming into
contact with connector 200 may affect the restraining force. In one
application, it may be easier to insert connector 200 into the incision
in the wall of the main vessel when front wing 232 is substantially
planar with an outer surface of connector 200.

[0054] Front wing 232 may also be configured to deploy from connector 200
when the restraining force is removed. For example, front wing 232 may be
configured to swing away from connector base 230 at front wing junction
233 when the restraining force is removed. In other examples, front wing
232 may be configured swing away from connector base 230 not as a
junction, but by bending one or more sections of front wing 232. When
deployed, front wing 232 may be configured to engage an inner surface of
an upper wall of the main vessel. Further discussion of this deployed
state is included below in FIG. 5, FIG. 6, and FIG. 7. In other examples,
connector base 230 may be implemented and configured differently and is
not limited to the descriptions provided.

[0055] In some examples, front wing 232 may include front tine 234. Front
tine 234 may be configured to securely engage with an inner surface of a
vessel. For example, front tine 234 may provide the securing means to
securely engage front wing 232 to an inner surface of an upper wall of
the main vessel. As shown here, one end of front tine 234 may be coupled
to front wing 232 while the other end of front tine 234 remains unfixed.
In some examples, front tine 234 may be composed of a memory material
that causes front tine 234 to change shape or position based upon
external forces. The memory material may be similar or substantially
similar to the memory material described in front wing 232 of FIG. 2. For
example, front tine 234 may be configured to be substantially planar (or
aligned) with an outer surface of connector 200 when a restraining force
is applied to front tine 234. In other words, the unfixed end of front
tine 234 may be aligned with an outer surface of connector 200. This
configuration may be desirable when inserting connector 200 into the
incision in the wall of the main vessel as it prevents the unfixed end of
front tine 234 from snagging or catching onto an edge of the incision
during insertion.

[0056] Alternatively, front tine 234 may be configured to deploy from
front wing 232 when the restraining force is removed. For example, front
tine 234 may be configured to swing away from front wing 232 at front
tine junction 235 when the restraining force is removed. In another
example, front tine 234 may be configured to form a curved shape when the
restraining force is removed. When deployed, front wing 232 may be
configured to securely engage an inner surface of an upper wall of the
main vessel. In some examples, front tine 234 and front wing 232 may
deploy simultaneously or in a specific order as determined by the
attributes of the memory material used in front tine 234 and front wing
232. Further discussion of this deployed state is included below in FIG.
5, FIG. 6, and FIG. 7. In other examples, connector tine 234 may be
implemented differently and are not limited to the examples shown and
described.

[0057] As shown here, connector body 220 may be integrated as part of
connector 200 and coupled to connector base 230. In some examples,
connector body 220 may include body tine 222. Body tine 222 may be
implemented similarly or substantially similar in function and structure
to front tine 234. In some examples, body tine 222 may be configured to
securely engage with an inner surface of a graft vessel. An unfixed end
of body tine 222 may provide a constant force against the inner surface
of the graft vessel that allows connector body 222 to be inserted into
the graft vessel but does not allow connector body 222 to be pulled out
of the graft vessel. In other examples, connector body 220 may be
implemented differently and are not limited to the examples shown and
described.

[0058] As shown here, connector tip 210 may be integrated with connector
200 and disposed at an end of connector 200. In some examples, connector
tip 210 may be configured to be inserted into a graft vessel. To assist
in the insertion process, connector tip 210 may be configured to compress
when a substantially tangential force is applied to connector tip 210.
This force may cause the end of connector 200 to shrink, thus simplifying
the task of inserting the end of connector 200 into the graft vessel. In
other examples, connector tip 210 may be configured to maintain in the
shape of connector tip 210 when a substantially tangential force is
applied to connector 200. Changes in the shape of connector tip 210 may
be undesirable as they may result in pinching or otherwise limiting the
flow of fluids through connector 200. Here, connector tip 210 comprises a
wave-shaped pattern. The wave-shaped pattern is similar to a sinusoidal
wave and is configured to provide a compressible end to connector 200.
Furthermore, the wave-shaped pattern may retain its shape when
substantially tangential forces are applied to connector body 220. In
other examples, the above-described elements may be implemented
differently and are not limited to the examples shown and described.

[0059] FIG. 3 illustrates a side view of an exemplary sutureless vascular
anastomosis connector. Here, connector 300 includes connector tip 310,
connector body 320, body tines 322, connector base 330, barbs 332 and
335, barb junction 333, front wing 334, rear wing 336, and side wing 337.
Connector tip 310, connector body 320, body tines 322, and connector base
330 may be implemented similarly or substantially similar in function and
structure to like-named elements as shown and described in FIG. 2. As
shown here, connector body 320 and connector base 330 may intersect along
diagonal plane 340. In some examples, diagonal plane 340 may represent an
angle in which connector 300 and an attached graft vessel are coupled
with the main vessel. Thus, modifying diagonal plane 340 may alter the
angle in which the graft vessel is coupled with the main vessel.

[0060] Connector base 330 may include barb 332, barb 335, front wing 334,
side wing 337, and rear wing 336. In some examples, barbs 332, barb 335,
front wing 334, and rear wing 336 may be configured to couple connector
base 330 with the main vessel. In other examples, barbs 332 and 335,
front wing 334, rear wing 336, and side wing 337 may be composed of a
memory material with similar functionality as the memory material
described above in FIG. 1 and FIG. 2. As an example, the memory material
may cause barb 332, barb 335, front wing 334, or rear wing 336 to change
shape or position based upon external forces.

[0061] Barb 332 may be configured to be substantially planar with an outer
surface of connector 300 when a restraining force is applied to connector
barb 332. Alternatively, barb 332 may be configured to deploy from
connector 300 when the restraining force is removed. As an example, barb
332 may bend at barb junction 333 when a restraining force is removed,
thus deploying barb 332 from connector base 330. Alternatively, the
entire body of barb 332 may bend away from connector base 330. In other
examples, barb 332 may bend at different locations to deploy barb 332
from connector base 330. In some examples, barb junction 333 and side
wing 337 may bend simultaneously or in a specific order to deploy barb
332 from connector base 330. In other examples, barb 335 may be
configured to function similar to barb 333.

[0062] Front wing 334 and rear wing 336 may be configured to be
substantially planar with an outer surface of connector 300 when a
restraining force is applied to front wing 334 and rear wing 336.
Alternatively, front wing 334 and rear wing 336 may be configured to
deploy from connector 300 when the restraining force is removed. In some
examples, front wing 334 and rear wing 336 may be implemented similarly
or substantially similar in function and structure to front wing 232 as
shown and described in FIG. 2. In an example, front wing 334 and rear
wing 336 may be substantially parallel with diagonal plane 340 when
deployed. This may allow front wing 334 and rear wing 336 to contact the
inner surface of a main vessel when deployed. Further discussion of this
deployed state is included below in FIG. 5, FIG. 6, and FIG. 7. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0063] FIG. 4 illustrates a flat pattern of an exemplary sutureless
vascular anastomosis connector. Here, flat pattern 400 includes connector
tip 410, connector body 420, tines 421, pattern 422, connector base 430,
barbs 431, front wing 432, side wings 435 & 437, and rear wing 436. In
some examples, connector 200 in FIG. 2 or connector 300 in FIG. 3 may be
formed by applying flat pattern 400 to a tubular structure. For example,
a laser cutting apparatus may apply flat pattern 400 to a tube comprising
memory material to create connector 200 in FIG. 2 or connector 300 in
FIG. 3. As shown here, flat pattern 400 may include connector tip 410,
connector body 420, and connector base 430. Connector tip 410, in some
examples, may be formed to resemble a "wave" such that, when formed in a
substantially circular implementation, a wave-shaped muzzle is formed. In
some examples, connector tip 410, connector body 420, and connector base
430 may be implemented similarly or substantially similar in function and
structure to same-named elements in FIG. 2 and FIG. 3.

[0064] Connector body 420 may also include pattern 422. Pattern 422 may be
a mesh pattern, a wire frame pattern, a plurality of perforations, or any
combination of openings. In some examples, pattern 422 may be configured
to allow connector body 420 to graft with a surface of a vessel. When
grafted, the connector and the vessel may be securely coupled to one
another. As shown here, pattern 422 may be a wire frame. When inserted
into a graft vessel, the wire frame may selectively contact the inner
surface of the graft vessel. Over time, tissue along the inner surface of
the graft vessel may attach to the wire frame. This may lead to the
integration of the wire frame as part of the graft vessel.

[0065] In other examples, pattern 422 may be configured to control,
adjust, or modify the flexibility of connector body 420. The direction or
location of flex may be controlled, adjusted, or modified depending upon
pattern 422. In an example, the width and orientation of pattern 422 may
control the direction, the location, and the amount of flex in connector
body 420 when external forces are applied to connector body 420. In some
examples, the direction and amount of flex may be configured to prevent
pinching or other limitations to the flow of fluids through connector
body 420. In other examples, the amount of flex may be configured to
relieve pressure to the wall of the graft vessel. For example, when
external forces are applied to the wall of a graft vessel, pressure on
the wall of the graft vessel may result. A connector body that is
flexible may slightly bend in the presence of pressure, therefore
relieving and dampening the pressure. This may minimize damage to the
wall of the graft vessel. In other examples, the above-described elements
may be implemented differently and are not limited to the examples shown
and described.

[0067] Body tines 510, when deployed, may have a fixed end attached to
connector body 502 and an unfixed end curving away from connector body
502. The radius of curvature of body tines 510 may be predetermined.
Alternatively, the unfixed end may bend away from connector body 502 at a
junction. In examples where body tines 510 are made of a memory material,
the unfixed end may be disposed when a force is applied to the unfixed
end. The displacement may cause the radius of curvature of body tines 510
to change. In some examples, the amount of displacement may depend upon
the shape of body tines 510 or the material memory in body tines 510. For
example, a thinner body tine may be easier to bend than a thicker body
tine, thus resulting in a larger change in radius of curvature when the
force is applied. In another example, body tines 510 may be configured to
not break or crack when force is applied. When disposed, the unfixed end
may exert an opposing force as the applied force. The opposing force may
attempt to return body tines 510 to its predetermined shape. As an
example, the opposing force may be in the opposite direction as the
applied force. In other examples, the opposing force may be depend upon
the radius of curvature of body tines 510 or the material memory in body
tines 510. For example, the opposing force may be directly proportional
to the radius of curvature of body tines 510. Alternatively, the opposing
force may be constant. When the applied force is removed from body tines
510, body tines 510 may return its predetermined radius of curvature and
the opposing force may no longer exist.

[0068] Connector body 502 may be configured to be inserted into a graft
vessel. In some examples, an inner diameter of the graft vessel may be
the same or substantially the same as an outer diameter of connector body
502. When connector body 502 is inserted, rolled, or otherwise disposed
alongside the outer surface of the graft vessel, the insertion may cause
an inner surface of the graft vessel to apply a force on the unfixed end
of body tines 510, thus displacing body tines 510. In response, body
tines 510 may exert an opposing force on the inner surface of the graft
vessel. Depending on the orientation of body tines 510, the opposing
force may cause the unfixed end of body tines 510 to securely engage the
inner surface of the graft vessel, thus preventing connector body 502
from moving in a specified direction. For example, body tines 510 may be
configured to restrict the graft vessel from moving in the opposite
direction as the unfixed end while allowing a graft vessel to move in the
same direction as the unfixed end. In other words, the orientation of
body tines 510 may affect the allowable direction of movement between
connector 500 and the graft vessel. As shown here, the unfixed end of
body tine 522 may be pointed towards connector base 503 and thus
preventing the graft vessel from being pulled back after insertion has
taken place. In yet other examples, connector body 502 may contain more
body tines to better control or limit the movement of the graft vessel
with respect to connector 500.

[0069] Barb 520, when deployed, may have a fixed end attached to connector
base 503 and an unfixed end that deploys from connector base 503. In an
example, the unfixed end may be coupled to a deployable side wing
(similar to side wing 337 in FIG. 3) and be configured to swing away from
the outer surface of connector base 503 at barb junction 521. The
deployable side wing and barb 520 may together provide a wide variety of
deployment configurations varying in position and angle for barb 520. In
some examples, the unfixed end may be configured to puncture an upper
wall of a main vessel and engage with a slot in an incision seal. For
example, the unfixed end of barb 520 may be shaped as a half arrow that
is configured to puncture the wall of the main vessel and not be readily
removable from the wall of the main vessel once punctured. As another
example, the unfixed end of barb 520 may include a sharp end and a
protrusion. The sharp end may be configured to puncture the wall of the
main vessel while the protrusion may be configured to lock with a slot.
When locked with the slot in the incision seal, connector 500 and the
incision seal may provide a clamping force to a portion of the wall of
the main vessel. To disengage the incision seal from connector 500, a
surgeon may exert a force on the protrusion to cause barb 520 to unlock
with the slot. As shown here, barb 520 may be angled away from connector
520 when in a deployed state. However, it is understood that barb 520 may
also deploy at different angles. In other examples, the above-described
elements may be implemented differently and are not limited to the
examples shown and described.

[0071] As shown here, front wing 630 and rear wing 640 may be disposed on
opposing sides of connector base 603. In some examples, front wing 630
and rear wing 640 may be configured to swing away from connector base 603
when deployed. For example, when connector base 603 has been inserted
into a main vessel, front wing 630 and rear wing 640 may swing away from
connector base 603 and engage an inner surface of the main vessel. In
other examples, front wing 630 and rear wing 640 may be configured to
swing away from connector base 603 until front wing 630 and rear wing 640
are substantially parallel with one another. Here, front wing 630 and
rear wing 640 may be swing away from connector base 630 until they are
substantially aligned with plane 650. Plane 650 may represent the
intersection between connector body 602 and connector base 603. In some
examples, plane 650 may divide the connector 600 into two portions, the
first portion remaining inside the main vessel and the second portion
remaining outside the main vessel.

[0072] In some examples, the mechanical motion resulting from front wing
630 and rear wing 640 swinging away from connector base 603 may be
different. For example, front wing 630 may swing away from connector base
603 at front hinge 631. This may allow front wing 630 to substantially
maintain its shape while changing its position or orientation. Similarly,
rear wing 640 may swing away from connector base 603 at rear hinge 641.
In other examples, the shape or the radius of curvature of front wing 630
may change when being deployed. For example, the shape of front wing 630
may change to conform with the inner surface of a main vessel when front
wing 630 is deployed. Front wing 630 may change curvature, orientation,
or shape in order to remain substantially flush with an inner surface of
the main vessel. In some examples, rear wing 640 may be implemented
similarly or substantially similar in function and structure to front
wing 630.

[0073] Front wing 630 may include front tine 635. In some examples, front
tine 635 may be implemented similarly or substantially similar in
function and structure to body tine 510 in FIG. 5. When deployed, front
tine 635 may include a fixed end attached to front wing 630 and an
unfixed end curving away from front wing 630. As an example, the unfixed
end of front tine 635 may be configured to contact, penetrate, or grasp
an inner surface of the main vessel. In other words, front tine 635 may
be configured to securely engage with the main vessel. In some examples,
the curvature, orientation, and shape of front tine 635 may affect the
way or manner that front tine 635 securely engages with the main vessel.
For example, the unfixed end of front tine 635 may be configured to
securely engage with the inner surface of the main vessel in a
unidirectional manner. As shown here, front tine 635 may be configured to
prevent removing the main vessel away from connector 600. When the main
vessel is moved away from connector 600, the unfixed end of front tine
635 may engage with the inner surface of the main vessel to prevent
movement in that direction. In some examples, the engagement may be by
penetrating or grasping the inner surface of the main vessel.
Alternatively, front tine 635 may be configured to not engage with the
inner surface of the main vessel when the main vessel moves towards
connector 600. In other words, front tine 635 may be configured to allow
the main vessel to move towards connector 600. In some examples, rear
tine 645 may be implemented similarly or substantially similar in
function and structure to front tine 635. In other examples, front wing
630 and front tine 635 may be configured to operate as a single unit.

[0074] In some examples, front tine 635 and rear tine 645 may be
configured to support an incision in a wall of the main vessel. Support
may include preventing connector 600 from undesirable movements that may
expand, stretch or otherwise enlarge the size of the incision. An
enlarged incision may be too large to be sealed by the connector and the
incision seal without the use of sutures. Thus, it may be desirable to
limit the movements of connector 600 once connector 600 has been secured
to the main vessel. For example, front tine 635 and rear tine 645 may be
configured to prevent undesirable axial movements from connector 600 by
piercing and grasping onto an inner surface of the main vessel. In
another example, front tine 635 and rear tine 645 may be configured to
prevent undesirable longitudinal movements from connector 600. As shown
here, the unfixed ends of front tine 635 and rear tine 645 may be
configured to point towards connector 600. In this configuration, front
tine 635 and rear tine 645 may work together to prevent undesirable
longitudinal movements from connector 600. Front tine 635 may securely
engage with an inner surface of the main vessel when connector 600 is
moved longitudinally in the direction of front wing 630. Similarly, rear
tine 635 may securely engage with an inner surface of the main vessel
when connector 600 is moved longitudinally in the direction of rear tine
645. Thus, the combination of front tine 635 and rear tine 645 may
restrict connector 600 from longitudinal movements. In some examples,
front tine 635 and rear tine 645 may be configured to securely engage the
inner surface of the wall of the main vessel at two points along a
centerline of the incision. In other examples, front tine 635 and rear
tine 645 may be configured to engage in other locations surrounding the
incision.

[0075] As shown here, barb 620 may be deployed from connector 600. In some
examples, connector 600 may include additional barbs that, in conjunction
with barb 620, may be configured to puncture a wall of a main vessel and
couple with one or more slots in an incision seal. Additional barbs may
assist in stabilizing the coupling of connector 600 with the incision
seal by limiting the axial movements and lateral movements of connector
600. These additional barbs may be the same length or different length as
barb 620. Here, connector 600 may include a pair of barbs facing away
from each other. The pair of barbs may be configured to deploy together
and lock with a pair of slots in the incision seal. In some examples,
barb 620 may include an end fixed to connector base 603 and an unfixed
end. The unfixed end of barb 620 may include a sharp end configured to
puncture a wall of a main vessel and a protrusion configured to lock with
a slot. To release the locking of the incision seal with connector 600, a
surgeon may exert a force on the protrusion causing barb 620 to unlock
with the slot. In other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0077] As shown here, connector body 702 may include a tubular interior
with inner diameter 770. Connector body 702 may be configured to transfer
fluids, such as blood, between two ends of connector 700. For example,
connector body may be configured to transfer blood between a graft vessel
and a main vessel. In other examples, connector body 700 may have a
differently shaped hollow center.

[0078] Connector body 702 may also have a tubular exterior with outer
diameter 780. Outer diameter 780 may be configured to be substantially
similar to the diameter of an inner surface of the graft vessel. In some
examples, body tines 712-718, when deployed, may be configured to extend
from outer diameter 780 to tine diameter 790 and engage with the inner
surface of the graft vessel. When engaged with the inner surface of the
graft vessel, body tines 712-718 may provide a restraining force that
restricts the movement of the graft vessel. The restraining force may be
configured based upon the orientation of body tines 712-718. In some
examples, the restrictions in movement may be direction-orientated, thus
allowing the graft vessel to move in some directions but not in others.
Here, body tines 712-718 may be configured to have unfixed ends pointing
towards the connector base, thus provide a restraining force that
prevents axial movements of connector 700 but allows longitudinal
movements of connector 700 towards the connector base. In another
example, body tines 712-718 may be positioned uniformly around connector
body 702 to provide a consistent restraining force on the inner surface
of the graft vessel. The consistent restraining force may be distributed
evenly along the inner surface of the graft vessel, thus reducing the
likelihood of tears caused by undue stress on the inner surface of the
graft vessel. In other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0079] FIG. 8 illustrates a front view of an exemplary incision seal.
Incision seal 800 may be configured to support the coupling between a
graft vessel and a main vessel. As shown here, incision seal 800 includes
latching ports 802-804, base 810, and recess 820. In some examples,
latching ports 802-804 may be configured to receive barbs (not shown)
from a connector (not shown) to which incision seal 800 is coupled, as
described in greater detail below. As shown, recess 820 may be located
along the length of base 810. In other examples, recess 820 may be shaped
as a hollow channel, a tunnel, or other shaped opening. As an example,
recess 820 may be configured to receive a portion of an upper wall of the
main vessel. The portion of the upper wall of the main vessel may be
protected or supported by incision seal 800 when the portion is received
by recess 820. In an example, the recess may have a curvature that is
substantially the same as the curvature of a portion of the upper outer
wall of the main vessel. When incision seal 800 is placed on the portion
of the upper outer wall of the main vessel, the recess may sit flush with
the portion of the upper outer wall of the main vessel, thus covering up
the portion of the upper outer wall of the main vessel. In some examples,
recess 820 may sit flush against an incision in the upper outer wall of
the main vessel. When recess 820 is placed flush against the incision,
incision seal 800 may cover, protect, seal, or support the incision and
the area surrounding the incision. Incision seal 800 may be made from
synthetic materials such as plastics or other elastomeric materials. In
other examples, the above-described elements and their design or function
may be implemented differently and are not limited to the examples shown
and described.

[0080] FIG. 9 illustrates a back view of an exemplary incision seal. Here,
incision seal 900 may include base 910, recess 920, housing opening 930,
and radius ring 940. In some examples, base 910 and recess 920 may be
implemented similarly or substantially similar in function and structure
to like-named elements as shown and described in FIG. 8. Housing opening
930 may be configured to receive a graft vessel. In some examples, the
structure of housing opening 930 may be a receptacle, hollow channel, or
other hollow channel that intersects incision seal 900. Housing opening
930 may provide a lumen for the graft vessel to be threaded through
incision seal 900. In some examples, housing opening 930 may have a
diameter. The diameter may be adjusted to accommodate graft vessels of
various sizes. Alternatively, the diameter may be adjusted to change the
fit of the graft vessel in housing opening 930. Here, housing opening 930
may be a hollow cylindrical structure with a diameter approximately equal
to the outer surface of a graft vessel. The hollow cylindrical structure
may provide a snug fit when the graft vessel is inserted into housing
opening 930.

[0081] In some examples, housing opening 930 may intersect recess 920,
thus coupling recess 920 with housing opening 930. This may provide a
lumen for objects inserted into housing opening 930 to reach recess 920,
or vice versa. Here, housing opening 930 and recess 920 may be configured
to accommodate the junction of a graft vessel with a main vessel. For
example, an incision of a main vessel may be covered by recess 920 while
a graft vessel inserted into housing opening 930 may reach an incision in
a main vessel. When a graft vessel is in contact with a main vessel, the
two vessels may slowly graft together to form an integrated structure.
Incision seal 900 may protect or support the junction between the graft
vessel and the main vessel before the two vessels fully graft onto one
another.

[0082] As shown here, housing opening 930 may further include radius ring
940 along an entrance of housing opening 930. Radius ring 940 may be
configured to ease the insertion of a graft vessel into housing opening
930 by providing a larger aperture for insertion. In some examples,
Radius ring 940 may have the same centerline as housing 930. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0083] FIG. 10 illustrates a side view of an exemplary incision seal.
Here, incision seal 1000 includes slots 1010 and 1020, latch pocket 1014
and 1024, ports 1012 and 1022, and base 1050. In some examples, base 1050
may be implemented similarly or substantially similar in function and
structure to like-named elements as shown and described in FIG. 8 and
FIG. 9. Slot 1010 and slot 1020 may be configured to engage a pair of
barbs to secure a connector with incision seal 1000. As shown here, slot
1010 may include port 1012 and latch pocket 1014. Port 1012 may be
configured to receive a barb (not shown). After the barb is received by
port 1012, a barb may engage with latch pocket 1014, thus locking the
barb in place. For example, a portion of a barb may be seated on latch
pocket 1014, thus preventing the barb from retracting through port 1012.
Once the barb is locked, incision seal 1000 may be securely coupled to
the connector. As an example, a barb may automatically engage with latch
pocket 1014 once the barb has been inserted into port 1012 by a
pre-determined amount. To uncouple incision seal 1000 from the connector,
a force may be applied to a barb to disengage the barb from latch pocket
1014 thus allowing the barb to retract through port 1012. Structurally,
port 1012 and latch pocket 1014 may be a variety of shapes including
square, rectangular, triangular, and semi-circular, to name a few. In
some examples, slot 1020 may include port 1022 and latch pocket 1024.
Port 1022 and latch pocket 1024 may be implemented similarly or
substantially similar in function and structure as port 1012 and latch
pocket 1014 as described above.

[0084] In some examples, the configuration of slots 1010 and 1020 in
incision seal 1000 may vary depending on application. As an example, the
number of slots used to securely couple incision seal 1000 with a
connector (not shown) may vary. In general, incision seal 1000 may be
more securely coupled with the connector when incision seal 1000 includes
more slots. However, additional slots may increase the difficulty to
unlock a connector from incision seal 1000. As another example, the
orientation of slots 1010 or 1020 may also be varied. As shown here, slot
1010 and slot 1020 may be configured to have port 1012 and port 1022
closer to one another than latch pocket 1014 and latch pocket 1024. In
other words, slot 1010 and slot 1020 may be oriented in different
directions. In some examples, an independent force may be applied to
unlock each slot. Thus, two forces applied in different directions may be
used to unlock the connector from incision seal 1000 when slot 1010 and
slot 1020 are oriented in different directions. For example, slot 1010
may require a force in the direction of latch pocket 1014 to port 1012 to
unlock the barb from slot 1010. Similarly, slot 1020 may require a force
in the direction of latch pocket 1024 to port 1022 to unlock the barb
from slot 1020. These different forces may decrease the likelihood that
the connector accidentally unlocks from incision seal 1000. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0085] FIG. 11 illustrates a perspective view of an exemplary incision
seal. As shown here, incision seal 1100 may include recess 1150, slots
1152-1154, groove 1110, guide 1112, guide 1114, slot 1122, and slot 1124.
Recess 1150, slot 1122, and slot 1124 may be implemented similarly or
substantially similar in function and structure to like-named elements as
shown and described in FIG. 8 and FIG. 9, and FIG. 10. Groove 1110 may be
configured to receive a connector (not shown). Once received, the
connector may lock with incision seal 1100 using slot 1122 and slot 1124.
In an example, the connector may be securely coupled with incision seal
1100 when barbs belonging to a connector are inserted into and locked
with slot 1122 and slot 1124. In another example, a connector and
incision seal 1100 may create a clamping force on a wall of a vessel when
the connector is locked with the incision seal. This clamping force may
securely couple the end of the graft vessel to an incision in the wall of
a main vessel. Securely coupling the two vessels together may prevent
fluids from leaking at the junction or provide support for the junction.
Over time, the graft vessel and the main vessel may graft with one
another, thus forming an integrated vessel. In some examples, groove 1110
may be formed by removing a portion of incision seal 1100 from recess
1150. In other examples, groove 1110 may be formed by removing a portion
of incision seal 1100 from a lumen in incision seal 1110.

[0086] As shown here, incision seal 1100 may also include guide 1112 and
guide 1114. Guide 1112 and guide 1114 may be configured to guide a barb,
a part of a fastener, or other locking component from the connector to
incision seal 1100. Structurally, guide 1112 and guide 1114 may be a
trench, channel, or other cut-out along groove 1110. In an example, guide
1112 and guide 1114 may be parallel with one another and be disposed
along two edges of groove 1110. In some examples, guide 1112 may
intersect slot 1122. A barb or other locking component traveling along
guide 1112 may enter slot 1122. In other words, guide 1112 may guide the
barb, the part of a faster, or other locking component into slot 1122
where the two may mate or lock with one another. Similarly, guide 1114
may intersect slot 1124 and be configured to guide a barb or other
locking component into slot 1124 where the two may mate or lock with one
another. In other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0087] FIGS. 12-31 illustrate exemplary processes for coupling a graft
vessel to a main vessel. For example, the process shown in FIG. 12 to
FIG. 31 may be used to perform a sutureless vascular anastomosis
procedure using a connector, incision seal, and other elements as shown
and described herein. In some examples, these processes may be performed
in the order shown or any variation thereof. In other examples, other
processes (not shown) may also be performed. In yet other examples, other
processes for coupling a graft vessel to a main vessel may use some or
all of the techniques illustrated in FIG. 12 to FIG. 31.

[0088] FIG. 12 illustrates an exemplary incision seal receiving a graft
vessel. Here, system 1200 may include graft vessel 1210 and incision seal
1220. In some examples, incision seal 1220 may be implemented similarly
or substantially similar in function and structure as like-named objects
shown in FIG. 8 to FIG. 11. A surgeon may insert and thread graft vessel
1210 through a housing in incision seal 1220. In an example, the housing
may include a recessed ring. In some examples, graft vessel 1210 may be
threaded through incision seal 1220 to keep incision seal 1220 away from
the end of graft vessel 1210. This may allow the surgeon to operate on
the end of graft vessel 1210 without interference from incision seal
1220. In other examples, the above-described elements may be implemented
differently and are not limited to the examples shown and described.

[0089] FIG. 13 illustrates an end of a graft vessel receiving an exemplary
sutureless vascular anastomosis connector. Here, system 1300 may include
graft vessel end 1310, connector 1320, and sheath 1330. Connector 1320
may be implemented similarly or substantially similar in function and
structure as like-named objects shown in FIG. 2 to FIG. 7. Connector 1320
may be partially covered by sheath 1330. As an example, sheath 1330 may
provide a restraining force on a connector base of connector 1320 to
prevent wings or barbs of the connector base from deploying. In another
example, sheath 1330 may provide a surface for a surgeon to grasp when
handling connector 1320. The surgeon may hold connector 1320 by sheath
1330 while inserting connector 1320 into graft vessel end 1310. In some
examples, the tip of connector 1320 may be contractible to ease the task
of inserting connector 1320 into graft vessel end 1310. In other
examples, connector 1320 may be securely coupled to graft vessel end 1310
when inserted. For example, the body of connector 1320 may include
retention spikes (i.e. tines) to securely engage the inner wall of the
graft vessel. Once the retention spikes are engaged, connector 1320 may
be securely coupled to graft vessel end 1310.

[0090] As shown here, sheath 1330 may include orientation guide 1335.
Orientation guide 1335 may be configured to guide the insertion of
connector 1320 into graft vessel end 1310 in the direction of the arrow
shown. In some examples, graft vessel end 1310 and sheath 1330 may both
contain an angular end. For example, graft vessel end 1310 and sheath
1330 may both contain an end at, for example, a 45-degree angle. In other
examples, the degree of orientation may be varied and is not limited to
45 degrees. Orientation guide 1335 may help ensure that the angular end
of graft vessel end 1310 aligns with the angular end of sheath 1330 by
placing a point of reference along the exterior of sheath 1330. This
point of reference may assist a surgeon in orienting connector 1310
during the insertion of connector 1320 into graft vessel end 1310.
Properly inserting connector 1320 into graft vessel end 1310 may ensure
that connector 1320 may be successfully deployed later on. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0091] FIG. 14 illustrates a side and cross-sectional view of loading an
exemplary sutureless vascular anastomosis connector into an introducer.
Here, system 1400 includes graft vessel 1410, connector 1420, sheath
1430, orientation guide 1435, introducer 1440, and tool 1450. Connector
1420 and sheath 1430 may be implemented similarly or substantially
similar in function and structure as like-named objects shown in FIG. 2
to FIG. 7 and FIG. 13. Connector 1420 may be disposed within and securely
coupled with graft vessel 1410 and sheath 1430. Moving one of these
coupled elements may result in similar movements from the other coupled
elements. Introducer 1440 may be configured to receive connector 1420 and
insert connector 1420 into a main vessel. As shown here, introducer 1440
may include lumen 1442 configured to receive graft vessel 1410, connector
1420, sheath 1430, or other object. Introducer 1440 may also include tip
1445 disposed on one end of lumen 1442. Tip 1445 may have an end that
includes one or more slits configured to remain closed when in a resting
state and open when a force is applied.

[0092] Here, sheath 1430 may be loaded into introducer 1440. This may
include inserting sheath 1430 into an opening of introducer 1440, such as
lumen 1442. In some examples, sheath 1430 may include orientation guide
1435. Orientation guide 1435 may be configured to orient sheath 1430
before insertion into lumen 1442. By orienting sheath 1430, connector
1420 may also be oriented since sheath 1430 is coupled to connector 1420.
Thus, connector 1420 may also be oriented before insertion into lumen
1442. As an example, orientation guide 1435 may be aligned with an index
key of introducer 1440 (not shown). When orientation guide 1435 is
inserted into the index key, sheath 1430 or connector 1420 may be
successfully oriented with respect to introducer 1440. In other examples,
the above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0093] FIG. 15 illustrates another side and cross-sectional view of
loading an exemplary sutureless vascular anastomosis connector into an
exemplary introducer. Here, system 1500 includes graft vessel 1510,
connector 1520, sheath 1530, introducer 1540, tip 1545, and tool 1550.
Connector 1520, sheath 1530, introducer 1540, and tip 1545 may be
implemented similarly or substantially similar in function and structure
as like-named elements shown in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 14.
Connector 1520 may be disposed within and securely coupled with graft
vessel 1510 and sheath 1530. Thus, moving one of these coupled elements
may result in similar movements from the other coupled elements. As an
example, connector 1520 may be securely coupled to graft vessel 1510 by
retention spikes (i.e. tines) of connector 1520. In another example,
connector 1520 may be securely coupled to sheath 1530 by a restrictive
force created from wedging connector 1520 and sheath 1530 through
introducer 1540.

[0094] As shown here, a force may be applied to sheath 1530 to insert
sheath 1530 into an opening of introducer 1540. In some examples, sheath
1530 may enter the opening, pass through a lumen of introducer 1540, and
exit an end of tip 1545. As sheath 1530 is inserted into introducer 1540,
sheath 1530 may remain securely coupled to connector 1520. As an example,
connector 1520 may have retention spikes (i.e. tines) that securely
contact the inner surface of sheath 1530 due to a restraining force
provided by the wall of the lumen. When sheath 1530 contacts the end of
tip 1545, the applied force may cause tip 1545 to open and accommodate
sleeve 1530. This may leave an exposed portion of sleeve 1530 outside the
end of tip 1545. As sheath 1530 is further inserted into the opening of
introducer 1540, tip 1545 may expand or retract to accommodate the outer
surface of sleeve 1530 while the exposed portion of sleeve 1530 may
increase. In some examples, the exposed portion may be grasped and
pulled. Pulling sheath 1530 may result in the coupled connector 1520 and
graft vessel 1510 to also be pulled towards tip 1545. When sheath 1530
exits the end of introducer 1540, connector 1520 and grafting vessel 1510
may be properly seated in introducer 1540. In other examples, the
above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0095] FIG. 16 illustrates a further side and cross-sectional view of
exemplary sutureless vascular anastomosis connector loaded into an
exemplary introducer. Here, system 1600 includes graft vessel 1610,
connector 1620, introducer 1640, tip 1645, and tool 1650. Connector 1620,
introducer 1640, and tip 1645 may be implemented similarly or
substantially similar in function and structure as like-named objects
shown and described in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 15. As shown
here, graft vessel 1610 may be disposed within introducer 1640 so that an
angled end of graft vessel 1610 may be parallel with an exterior surface
of introducer 1640. Moreover, connector 1620 may be disposed within
introducer 1640 and reside within tip 1645. Tip 1645 may be configured to
shield connector 1620 during insertion into the main vessel. Using tool
1650, tip 1645 may be used to prevent retention spikes (i.e. tines),
barbs, or other elements of connector 1620 from improperly engaging the
main vessel during insertion. In other examples, the above-described
elements may be implemented differently and are not limited to the
examples shown and described.

[0096] FIG. 17 illustrates a side and cross-sectional view of an exemplary
introducer entering an incision in a main vessel. Here, system 1700 may
include graft vessel 1710, main vessel 1720, incision 1725, tool 1730,
introducer 1740, and tip 1745. In some examples, introducer 1740 and tip
1745 may be implemented similarly or substantially similar in function
and structure as like-named objects shown and described in FIG. 13 to
FIG. 16. Graft vessel 1710 may be securely coupled to a connector (not
shown). The connector may be configured to be inserted and securely
coupled to a main vessel to join the main vessel with graft vessel 1710.
Thus, the connector may serve as the coupling component to couple graft
vessel 1710 with main vessel 1720. Here, introducer 1740 may be
configured to insert the connector into the main vessel. Introducer 1740,
while housing graft vessel 1710 and the connector, may be inserted into
incision 1725 at an angle. As an example, tip 1745 of introducer 1740 may
be inserted into incision 1725. In other examples, the above-described
elements may be implemented differently and are not limited to the
examples shown and described.

[0097] FIG. 18 illustrates a side and cross-sectional view of an exemplary
introducer disposed within an incision in a main vessel. As shown here,
system 1800 may include graft vessel 1810, main vessel 1820, incision
1825, introducer 1840, and tip 1845. Introducer 1840 and tip 1845 may be
implemented similarly or substantially similar in function and structure
as like-named objects shown and described in FIG. 13 to FIG. 17. An end
of graft vessel 1810 may be securely coupled to a connector (not shown),
where the end of graft vessel 1810 and the connector are both housed
within introducer 1840. Here, introducer 1840 may be inserted into
incision 1825 of main vessel 1820. As an example, tip 1845 of inserter
1840 may be disposed within main vessel 1820 when introducer 1840 is
inserted. This may cause a surface of inserted introducer 1840 to abut a
portion of the wall of main vessel 1820 surrounding incision 1825. In
some examples, a diameter of tip 1845 may be approximately the same as a
diameter of graft vessel 1810. In other examples, the above-described
elements may be implemented differently and are not limited to the
examples shown and described.

[0098] FIG. 19 illustrates a side and cross-sectional view of an exemplary
introducer inserting an exemplary sutureless vascular anastomosis
connector inside a main vessel. As shown here, system 1900 may include
graft vessel 1910, main vessel 1920, incision 1925, introducer 1940, tip
1945, connector 1950, deployment rod 1960, and tool 1970. Introducer
1940, tip 1945, and connector 1950 may be implemented similarly or
substantially similar in function and structure as like-named objects
shown and described in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 18.
Introducer 1940 may be configured to insert or introduce connector 1950
into main vessel 1920. For example, tip 1945 of introducer 1940 may be
inserted into incision 1925 and a surface of introducer 1940 may overlap
an exterior surface surrounding incision 1925. In other words, introducer
1940 may be positioned so that tip 1945 is inserted into incision 1925 of
main vessel 1920 and a surface of introducer 1940 is aligned with or
flush against a wall of main vessel 1920. Introducer 1940 may remain in
this position during the insertion or introduction of connector 1950 into
main vessel 1920.

[0099] In some examples, connector 1950 and graft vessel 1910 may be
pushed through introducer 1940. As an example, rod 1960 may serve as an
insertion instrument configured to contact connector 1950 to push
connector 1950 towards tip 1945. In an example, connector 1950 may be
pushed through introducer 1940, extend out of tip 1945, and enter into
main vessel 1920. As connector 1950 extends out of tip 1945, tip 1945 may
expand to accommodate connector 1950. In some examples, connector 1950
may be inserted into main vessel 1920 while introducer 1940 remains flush
against a wall of main vessel 1920 with tip 1945 inserted into main
vessel 1920. In other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0100] FIG. 20 illustrates a side and cross-sectional view of an exemplary
introducer deploying an exemplary sutureless vascular anastomosis
connector in a main vessel. As shown here, system 2000 may include graft
vessel 2010, main vessel 2020, incision 2025, introducer 2040, tip 2045,
connector 2050, front wing 2052, rear wing 2054, barb 2036, and tool
2070. Introducer 2040, tip 2045, and connector 2050, front wing 2052,
rear wing 2054, and barb 2036 may be implemented similarly or
substantially similar in function and structure as like-named objects
shown and described in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 19.
Introducer 2040 may be configured to insert or introduce connector 2050
in main vessel 2020. In some examples, this may be a two step process. In
a first step, tip 2045 may be inserted within main vessel 2020 with
connector 2050 located within tip 2045. In a second step, tip 2045 may be
retracted from main vessel 2020 while leaving connector 2050 within main
vessel 2020.

[0101] As shown here, rod 2060 may be configured to control the position
of connector 2050. In some examples, a pushing force may be applied to
rod 2060 to change the position of connector 2050 with respect to main
vessel 2020. For example, the pushing force may cause rod 2060 to contact
and push connector 2050 further into main vessel 2020. The contact point
may be a wing, a tine, a barb, or other slight protrusion along the
exterior surface of connector 2050. In other examples, a maintaining
force may be applied to rod 2060 to maintain the position of connector
2050 in main vessel 2020. For example, the maintaining force may be
applied to rod 2060 to maintain the position of connector 2050 while a
lifting force may be applied to introducer 2040 to remove introducer 2040
away from main vessel 2020. When the lifting force is applied, introducer
2040 and tip 2045 may travel along the shaft of graft vessel 2010 away
from main vessel 2020. This may cause tip 2045 to expand or reduce to
accommodate the exterior surface of connector 2050 and graft vessel 2010.
For example, tip 2045 may expand to approximately the same circumference
as graft vessel 2010. As tip 2045 is retracted from main vessel 2020,
connector 2050 may be exposed from an end of tip 2045 and remain within
main vessel 2020. Eventually, connector 2050 may be entirely exposed from
tip 2045 and disposed inside main vessel 2020.

[0102] In some examples, tip 2045 may apply a restraining force on
connector 2050. The restraining force may prevent front wing 2052, rear
wing 2054, and barb 2036 from deploying while connector 2050 is disposed
within tip 2045. As tip 2045 is removed from main vessel 2020, a portion
of connector 2050 may become exposed from an end of tip 2045. The exposed
portion may be relieved from the restraining force. Thus, front wing
2052, rear wing 2054, and barb 2036 may deploy from connector 2050 once
they belong to the exposed portion. Once deployed, these elements may
securely engage with an interior surface of main vessel 2020. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0103] FIG. 21 illustrates an exemplary introducer encompassing a graft
vessel. As shown here, system 2100 may include graft vessel 2110, main
vessel 2120, introducer 2140, and slit 2141. Introducer 2140 may be
implemented similarly or substantially similar in function and structure
as like-named objects shown and described in FIG. 14 to FIG. 20. A
by-product of coupling an end of graft vessel 2110 with a side of main
vessel 2120 may be introducer 2140 encompassing graft vessel 2110. It may
be desirable to remove introducer 2140 from graft vessel 2110 so that an
incision seal may be lowered onto main vessel 2120 and used to seal the
coupling of graft vessel 2110 with main vessel 2120.

[0104] Introducer 2140 may include slit 2141. Slit 2141 may be configured
to remove introducer 2140 from graft vessel 2110 by splitting introducer
2140 into multiple parts. In other words, slit 2141 may provide a means
for splitting and removing introducer 2140 from graft vessel 2120. Here,
slit 2141 may be disposed on a plane that bisects introducer 2140 into
two equal parts. When a detaching force is applied to introducer 2140,
introducer 2140 may split into two equal parts along slit 2141. In other
examples, multiple slits may be disposed along multiple planes of
introducer 2140. These multiple slits may divide introducer 2140 into
multiple parts when a detaching force is applied. In yet other examples,
the above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0105] FIG. 22 illustrates an exemplary introducer detaching from a graft
vessel. As shown here, system 2200 may include graft vessel 2210, main
vessel 2220, introducer part 2242 and introducer part 2244. Initially, an
introducer may be encompassing graft vessel 2210. After a detaching force
is applied, the introducer may split along a plane intersecting the
introducer to form introducer part 2242 and introducer part 2244. Once
split, introduce part 2242 and introducer part 2244 may no longer
encompass graft vessel 2210 and thus, may be removed system 2200. In
other examples, the above-described elements may be implemented
differently and are not limited to the examples shown and described.

[0106] FIG. 23 illustrates an exemplary barb-setting device. Here, system
2300 may include graft vessel 2310, main vessel 2320, incision seal 2330,
and barb-setting device 2340. In some examples, barb-setting device 2340
may also be referred to as a "tool." As shown, incision seal 2330 may be
implemented similarly or substantially similar in function and structure
as like-named objects shown and described in FIG. 8 to FIG. 11. As shown
here, barb-setting device 2340 may be in an open position. Barb-setting
device 2340 may be configured to cause one or more barbs belonging to a
connector within main vessel 2320 to puncture a wall of the main vessel.
The punctured barbs may subsequently lock with incision seal 2330.
Structurally, barb-setting device 2340 may include two components hinged
together in a similar fashion as a traditional pair of pliers. The first
component may include an end having a semi-cylindrical structure
configured to longitudinally receive main vessel 2320. In an example, the
semi-cylindrical structure may further include one or more openings
configured to accommodate one or more barbs. In another example, the
semi-cylindrical structure may be slotted on one end to receive graft
vessel 2310. The slot may allow the junction between graft vessel 2310
and main vessel 2320 to be disposed in the middle of the semi-cylindrical
structure. This may result in more uniform distribution of force on graft
vessel 2310 and main vessel 2320 when a clenching force is applied to
barb-setting device 2340. The second component of barb-setting device
2340 may also be configured to longitudinally receive main vessel 2320.
Together, the first component and second component may clench main vessel
2320 thus causing one or more barbs to pierce the main vessel. In some
examples, barb-setting device 2340 may also securely engage wings or
tines of the connector with an inner surface of the main vessel. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0107] FIG. 24 illustrates a cross-sectional view of an exemplary
barb-setting device. Here, system 2400 may include graft vessel 2410,
main vessel 2420, connector 2430, barb-setting device 2440, opening 2442
and opening 2444. In some examples, connector 2430 and barb-setting
device 2440 may be implemented similarly or substantially similar in
function and structure as like-named objects shown and described in FIG.
2 to FIG. 7, FIG. 13 to FIG. 16, FIG. 19 to FIG. 20, and FIG. 23. As
shown here, barb-setting device 2440 may be in an open position.
Barb-setting device 2440 may be configured to cradle the junction between
graft vessel 2410 and main vessel 2420. Connector 2430 may be disposed
within main vessel 2420 and securely coupled to graft vessel 2410. In
some examples, barb-setting device 2440 may be configured to apply a
clenching force on the exterior surface of main vessel 2420 that causes
barbs, wings, or retention spikes (i.e. tines) of connector 2430 to
engage with an inner surface of main vessel 2420. For example, an upper
portion of barb-setting device 2440 may be configured to receive an upper
wall of main vessel 2420. The upper portion may also include opening 2442
and opening 2444 through which barbs of a connector (not shown) may be
inserted. Opening 2442 and opening 2444 may be configured to accommodate
one or more barbs that pierce the upper wall of main vessel 2420 when the
clenching force is applied. In another example, a lower portion of
barb-setting device 2440 may be configured to compress a bottom wall of
main vessel 2420. When compressed, the interior surface of the bottom
wall of main vessel 2420 may contact connector 2430, thus causing barbs
of connector 2430 to puncture main vessel 2420. In other examples, the
above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0108] FIG. 25 illustrates an exemplary barb-setting device. Here, system
2500 may include graft vessel 2510, main vessel 2520, incision seal 2530,
and barb-setting device 2540. In some examples, incision seal 2530 and
barb-setting device 2540 may be implemented similarly or substantially
similar in function and structure as like-named objects shown and
described in FIG. 8 to FIG. 11, FIG. 23, and FIG. 24. As shown here,
barb-setting device 2540 may be in a closed position. Barb-setting device
2540 may be configured to apply a clenching force to main vessel 2520. In
some examples, the clenching force may cause one or more barbs of a
connector disposed within main vessel 2520 to puncture a wall of main
vessel 2520. In other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0109] FIG. 26 illustrates a cross-sectional view of a barb-setting
device. Here, system 2600 may include graft vessel 2610, main vessel
2620, connector 2630, barb 2632, barb 2634, barb-setting device 2640,
opening 2642 and opening 2644. In some examples, connector 2630, barb
2632, and barb-setting device 2640 may be implemented similarly or
substantially similar in function and structure as like-named objects
shown and described in FIG. 2 to FIG. 7, FIG. 13 to FIG. 16, FIG. 19 to
FIG. 20, and FIG. 23 to FIG. 25. As shown here, barb-setting device 2640
may be in a closed position. Barb-setting device 2640 may be configured
to provide a clenching force on the outer surface of main vessel 2620
causing main vessel 2620 to deform, compress, or otherwise change shape.
Connector 2630 may be disposed within main vessel 2620 and securely
coupled to graft vessel 2610. In some examples, main vessel 2620 may
assume a shape that is substantially the same as the inner surface of the
upper and lower components of barb-setting device 2640. In other
examples, main vessel 2620 may assume other shapes. When in a compressed
state, an inner surface of main vessel 2620 may contact connector 2630,
thus causing connector 2630 to engage an inner surface of an upper wall
of main vessel 2620. For example, a wing of connector 2630 may engage an
inner surface of main vessel 2620 when main vessel 2620 is in a
compressed state. In another example, barb 2632 and barb 2634 of
connector 2630 may puncture a wall of main vessel 2620 when main vessel
2620 is in a compressed state. The punctured barbs may be disposed within
opening 2642 and opening 2644 of barb-setting device 2640. When the
clenching force is removed, main vessel 2620 may return to its original
shape while connector 2630 remains engaged with an inner surface of an
upper wall of main vessel 2620. For example, barb 2632 and barb 2634 may
remain protruding from the exterior surface of main vessel 2620. In
another example, wings or tines of connector 2630 may remain engaged with
an inner surface of an upper wall of the main vessel. In yet other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0110] FIG. 27 illustrates an exemplary incision seal-setting device.
System 2700 may include graft vessel 2710, main vessel 2720, incision
seal 2730, and incision seal-setting device 2740. Incision seal 2730 may
be implemented similarly or substantially similar in function and
structure as like-named objects shown and described in FIG. 8 to FIG. 11.
As shown here, incision seal-setting device 2740 may be in an open
position. Incision seal-setting device 2740 may be configured to lock
incision seal 2730 with a connector disposed within main vessel 2720.
Incision seal 2730 may support graft vessel 2710 by encompassing graft
vessel 2710. Incision seal 2730 may also cover a junction between graft
vessel 2710 and main vessel 2720. Structurally, incision seal-setting
device 2740 may include two components hinged together in a similar
fashion as a traditional pair of pliers. The first component may include
an end having a semi-cylindrical structure configured to longitudinally
receive main vessel 2720 and incision seal 2730. In an example, the
semi-cylindrical structure may be slotted on one end to receive graft
vessel 2710 and incision seal 2730. The slot may allow the junction
between graft vessel 2710 and main vessel 2720 to be disposed in the
middle of the semi-cylindrical structure. The second component of
incision seal-setting device 2740 may also be configured to
longitudinally receive main vessel 2720. Together, the first component
and second component may clench together incision seal 2730 with a
connector within main vessel 2720, thus causing one or more barbs to lock
with incision seal 2730. In some examples, the integrated structure
(i.e., first and second components, incision seal 2730, and a connector
(not shown)) may provide a clamping force on the portion of the main
vessel between incision seal 2730 and the connector. In other examples,
the above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0111] FIG. 28 illustrates a cross-sectional view of an exemplary incision
seal-setting device. Here, system 2800 is a general illustration that
includes graft vessel 2810, main vessel 2820, incision seal 2830,
incision seal-setting device 2840, connector 2850, barb 2852, and barb
2854. In some examples, incision seal 2830, incision seal-setting device
2840, connector 2850, barb 2852, and barb 2854 may be implemented
similarly or substantially similar in function and structure as
like-named objects shown and described in FIG. 2 to FIG. 16, FIG. 19 to
FIG. 20, and FIG. 23 to FIG. 27. As shown here, incision seal-setting
device 2840 may be in an open position. Incision seal 2830 may be
disposed in a position allowing barb 2852 and barb 2854 of connector 2850
to lock with incision seal 2830 when a clenching force is applied to
incision seal-setting device 2840. In some examples, an inner surface of
incision seal-setting device 2840 may be configured to receive incision
seal 2830 and main vessel 2820. In other examples, an inner surface of
incision seal setting device 2840 may be configured to deform, compress,
or otherwise change the shape of main vessel 2820. In yet other examples,
the above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0112] FIG. 29 illustrates an exemplary incision seal-setting device.
Here, system 2900 may include graft vessel 2910, main vessel 2920,
incision seal 2930, and incision seal setting device 2940. In some
examples, incision seal 2930 and incision seal-setting device 2940 may be
implemented similarly or substantially similar in function and structure
as like-named objects shown and described in FIG. 8 to FIG. 11 and FIG.
27 to FIG. 28. As shown here, incision seal setting device 2940 may be in
a closed position. Incision seal setting device 2940 may be configured to
apply a clenching force on main vessel 2920, incision seal 2930, and a
connector within main vessel 2920. When the clenching force is applied,
incision seal 2930 may lock with the connector. In some examples,
incision seal 2930 and the connector may create a clamping force when
locked. The clamping force may securely couple graft vessel 2910 to main
vessel 2920. In some examples, the clenching force may affect a portion
of main vessel 2920 overlapping incision seal 2930. In other examples,
the clenching force may have no affect on portions of main vessel 2920
that do not overlap incision seal 2930. In yet other examples, the
above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0113] FIG. 30 illustrates an exemplary incision seal setting device.
Here, system 3000 may include graft vessel 3010, main vessel 3020,
incision seal 3030, incision seal setting device 3040, connector 3050,
barb 3052, and barb 3054. In some examples, incision seal 3030, incision
seal setting device 3040, connector 3050, barb 3052, and barb 3054 may be
implemented similarly or substantially similar in function and structure
as like-named objects shown and described in FIG. 2 to FIG. 16, FIG. 19
to FIG. 20, and FIG. 23 to FIG. 29. As shown here, incision seal setting
device 3040 may be in a closed position when a clenching force is
applied. Incision seal setting device 3040 may be configured to lock
connector 3050 with incision seal 3030. For example, incision seal
setting device 3040 may compress main vessel 3020 to cause barb 3052 and
barb 3054 to lock with incision seal 3030. In some examples, an interior
surface of incision seal setting device 3040 may be configured to cause
main vessel 3020 to deform, compress, or otherwise change shape. In other
examples, the above-described elements may be implemented differently and
are not limited to the examples shown and described.

[0114] FIG. 31 illustrates an exploded view of an exemplary two-component
sutureless vascular anastomosis connector system. Here, system 3100 may
include graft vessel 3110, main vessel 3120, incision seal 3130, and
connector 3140. System 3100 may be configured to couple an end of graft
vessel 3110 with incision 3190 along a wall of main vessel 3120. In some
examples, incision seal 3130 and connector 3140 may be implemented
similarly or substantially similar in function and structure as
like-named objects shown and described in FIG. 2 to FIG. 16, FIG. 19 to
FIG. 20, and FIG. 23 to FIG. 29. As shown here, graft vessel 3110 may be
"sandwiched" (i.e., disposed between) in between incision seal 3130 and
connector 3140. In some examples, graft vessel 3110 may be securely held
in between connector 3140 and incision seal 3130 when connector 3140 is
in a deployed state (as shown in FIG. 31).

[0115] Main vessel 3120 may also be "sandwiched" (i.e., disposed between)
in between incision seal 3130 and connector 3140 when connector 3140 is
disposed within main vessel 3120. Connector 3140 and incision seal 3130
may be interlocked to provide a securing force that couples the connector
3140 to incision seal 3130. For example, the interlock may provide a
securing force that secures main vessel 3120 in between connector 3140
and incision seal 3130. In some examples, connector 3140 may also provide
a restraining force on the inner wall of main vessel 3120 that helps
maintain the position of the wall of the main vessel relative to
connector 3120. In yet another example, the interlock may provide
sufficient pressure to minimize leakage from the end of graft vessel
3110, the incision in main vessel 3120, or any holes on the wall of the
main vessel that may be covered by incision seal 3130. In other examples,
the above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0116] FIG. 32 illustrates an exploded view of an exemplary
three-component sutureless vascular anastomosis connector system. Here,
system 3200 may include graft vessel 3210, main vessel 3220, incision
seal 3230, connector 3240, and support tube 3250. In some examples,
incision seal 3230 and connector 3240 may be implemented similarly or
substantially similar in function and structure as like-named objects
shown and described in FIG. 2 to FIG. 16, FIG. 19 to FIG. 20, and FIG. 23
to FIG. 29. System 3200 may be configured to couple an end of graft
vessel 3210 with incision 3290 along a wall of main vessel 3220. As shown
here, graft vessel 3210 may be sandwiched in between support tube 3250
and connector 3240. In some examples, graft vessel 3210 may be securely
held in between connector 3240 and support tube 3250 when connector 3240
is deployed (as shown in FIG. 32). Incision seal 3230 may be configured
to receive support tube 3250 and securely couple with connector 3240 when
connector 3240 is disposed within main vessel 3220. This may minimize
leakage from being generated at or near the junction of the two vessels
by providing additional support to the junction. For example, an end of
support tube 3250 may firmly press the end of graft vessel 3240 against
the wall of main vessel 3220 when incision seal 3230 is securely coupled
with connector 3240. This may minimize leakage at the junction between
the two vessels. As another example, incision seal 3230 may firmly cover
an area of the wall of main vessel 3220 when incision seal 3230 is
securely coupled with connector 3240. This may minimize leakage from
holes in the area of the wall of main vessel 3220. In other examples, the
above-described elements may be implemented differently and are not
limited to the examples shown and described.

[0117] FIG. 33 illustrates an exemplary support tube. Here, support tube
3300 may include body 3310, ring 3320, and notch 3330. Support tube 3300
may be configured to secure a graft vessel firmly to a main vessel. This
may minimize leakage from the junction of the two vessels. As shown here,
body 3310 may comprise of a hollow tube having an inner diameter and an
outer diameter. The dimensions of body 3310 may be configured to allow
body 3310 to be disposed in between a graft vessel and an incision seal.
In some examples, the incision seal may be may be implemented similarly
or substantially similar in function and structure to like-named elements
as shown and described in FIG. 34. As an example, the inner diameter may
be substantially similar to the outer diameter of the graft vessel,
thereby allowing the graft vessel to fit snug within support tube 3300.
As another example, the outer diameter may be configured such that body
3310 fits snug within a lumen in between first housing opening 3430 and
second housing opening 3440 of incision seal 3400. In some examples, body
3310 may include an angled end. The angled end may be configured so that
support tube 3300 may securely contact a wall of a main vessel at a
pre-determined angle. As an example, the angled end may have
substantially the same angle as an end of a graft vessel. The end of the
graft vessel may be aligned with the angled end to allow the end of the
graft vessel and support tube 3300 to securely contact the wall of the
main vessel at the predetermined angle. In some examples, the angle at
the end of the graft vessel, the angled end of body 3310, and an angle of
a housing of an incision seal may all be substantially the same. This may
allow all three to securely contact the wall of the main vessel.

[0118] In some examples, the length of body 3310 may be configured as a
unit of measurement. For example, the length of body 3310 may be used as
a guide to measure the approximate length of the portion of the graft
vessel to be secured to a connector. This may be useful during the
preparation of the graft vessel for vascular anastomosis (as discussed in
FIG. 37). As an example, the length of body 3310 may be proportionate to
the length of a portion of the connector to be coupled to the graft
vessel. Thus, the length of body 3310 may be utilized as a measurement
for determining a portion of the graft vessel that will be coupled to the
connector. In some examples, the portion of the graft vessel measured may
be folded over the exterior surface of body 3310 to subsequently be used
to couple with the connector.

[0119] Support tube 3300 may further include ring 3320. Ring 3320 may be
disposed along a circumference of body 3310. As an example, ring 3320 may
be configured to couple with incision seal 3400. For example, ring 3320
may couple with groove 3450 of incision seal 3400 when support tube 3300
is received by incision seal 3400. When coupled, forces applied to
incision seal 3400 may also be applied to support tube 3300. For example,
a securing force applied to incision seal 3400 may also push support tube
3300 towards a wall of the main vessel. This may result in support tube
3300 firmly pressing an end of a graft vessel against the wall of the
main vessel. In some examples, this may minimize leakage at the junction
of the graft vessel and the main vessel. As an example, ring 3320 may be
disposed along the outer surface of body 3310 depending on the location
of groove 3450. For example, ring 3320 may be disposed at a position
allowing incision seal 3400 and support tube 3300 to contact the wall of
the main vessel when ring 3320 is coupled to groove 3450.

[0120] Support tube 3300 may further include notch 3330. Notch 3330 may be
coupled to an angled end of body 3310 and may be configured to provide
clearance for deployment of a wing belonging to a connector. In some
examples, notch 3330 may provide clearance for rear hinge 641 to deploy
rear wing 640 as shown and described in FIG. 6. Thus, the shape and
position of notch 3330 may be dependent on the shape rear hinge 641. In
another example, the shape and location of notch 3330 may be configured
to support rear wing 640. In yet another example, body 3310, ring 3320,
notch 3330, and angled edge 3340 may form a continuous tubular structure.
The material used to form support tube 3300 may be Teflon tubing. In
other examples, the above-described elements may be implemented
differently and are not limited to the examples shown and described.

[0121] FIG. 34 illustrates an exemplary incision seal. Here, incision seal
3400 may include base 3410, recess 3420, first housing opening 3430,
second housing opening 3440, and groove 3450. In some examples, base
3410, recess 3420, first housing opening 3430, and second housing opening
3440 may be implemented similarly or substantially similar in function
and structure to like-named elements as shown and described in FIG. 8 and
FIG. 9. As shown here, first housing opening 3430 may be disposed on an
outer surface of incision seal 3400 and be configured to provide a lumen
for objects inserted into first housing opening 3430 to reach second
housing opening 3440, or vice versa. Second housing opening 3430 may be
disposed on recess 3420 which is located along the length of base 3410.
In some examples, first housing opening 3430 and second housing opening
3440 may be of different shapes or sizes. The different sizes may provide
different functionality to the two ends of the lumen. For example, first
housing opening 3430 may be configured to support the coupling of a
connector and a graft vessel. In another example, second housing opening
3440 may be configured to support the coupling of the connector and a
main vessel. As shown here, second housing opening 3440 may be triangular
in shape and have rounded corners to accommodate the deployed wings or
barbs of the connector (as shown and describe in FIGS. 2-7), thereby
allowing the incision seal to seat securely on a wall of the main vessel
when the wings or barbs of the connector are deployed.

[0122] Incision seal 3400 may further include groove 3450. Groove 3450 may
be disposed within a lumen connecting first housing opening 3430 and
second housing opening 3440. As an example, groove 3450 may be configured
to contact a support tube inserted into second housing opening 3440. In
some examples, the support tube may be implemented similarly or
substantially similar in function and structure to support tube 3300 as
shown and described in FIG. 33. When ring 3320 of support tube 3300 and
groove 3450 are in contact, movements of incision seal 3400 may also
affect support tube 3300. For example, support tube 3300 and incision
seal 3400 may move in unison once contact has occurred. As an example,
groove 3450 may be a recessed ring located within the lumen. The recessed
ring may have a larger diameter than the diameter of the lumen. This may
prevent support tube 3300 from passing entirely through the lumen between
first housing opening 3430 and second housing opening 3440. In another
example, groove 3450 may be protrusion located within the lumen. In yet
other examples, groove 3450 may be any one or more shapes located within
the lumen that prevents ring 3320 disposed on a body of the support tube
from passing through.

[0123] Incision seal 3400 may comprise a medical grade material. In some
examples, the medical grade material may be transparent. This may allow a
surgeon to view the graft vessel and the main vessel when the two vessels
are coupled to one another. This may also help the surgeon locate the
source of any leakages creates from the coupling of the graft vessel and
the main vessel. In other examples, the medical grade material may be
malleable and capable of receiving and securely lodging an object within
incision seal 3400. This may allow incision seal 3400 to securely engage
with a connector without the use of slots or guides. In some examples,
the connector may be implemented similarly or substantially similar in
function and structure to the connector as shown and described in FIGS.
2-7. For example, barb 620 of FIG. 6 belonging to a connector 600 of FIG.
6 inserted inside a main vessel may pierce through a wall of the main
vessel and enter incision seal 3400 at an entry point. Once the barb 620
enters the malleable material of incision seal 3400, barb 620 may be
lodged within the malleable material, thus preventing removal of barb 620
from incision seal 3400. Depending upon the shape of barb 620, piercing
the wall of the main vessel may create an opening in the wall that is of
larger size than a base of barb 620. In some situations, the opening may
result in leakage of fluids from inside the main vessel.

[0124] In some examples, the medial grade material may be configured to
minimize the entry point of the fastener into incision seal 3400. This
may allow incision seal 3400 to maintain a substantially smooth surface
after barb 620 has entered incision seal 3400. As an example, the entry
point may expand when presented with wider portions of the fastener and
contract when presented with narrower portions of barb 620. This may
result in the malleable material forming a seal around barb 620,
regardless of the size or shape of the barb. Thus, when incision seal
3400 is seated on the wall of the main vessel, the substantially smooth
surface of incision seal 3400 may cover any openings in the wall of the
main vessel created from the fastener piercing the wall. This may
minimize the leakage from any openings in the wall of the main vessel.

[0125] As an example, incision seal 3400 may comprise of a silicone based
material. Barb 620 may pierce recess 3420 and become lodged (i.e.
secured) within the silicone based material. As barb 620 enters incision
seal 3400, the silicone based material may conform to the shape of barb
620, thus forming a tight seal between recess 3420 and the barb. The
tight seal may provide a substantially smooth and uniform surface along
recess 3420. This may allow recess 3420 to uniformly cover the wall of
the main vessel, thus minimizing any leakage coming from the main vessel.
As shown here, incision seal 3400 may be formed from a monolithic piece
of material. In other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0126] FIG. 35 illustrates a process flow diagram of an exemplary method
for performing sutureless vascular anastomosis. Method 3500 may couple a
graft vessel to an incision in a main vessel using a connector, an
incision seal, and a support tube. In some examples, the connector,
incision seal, and support tube may be implemented similarly or
substantially similar in function and structure as like-named elements
shown and described in FIG. 32 (e.g., graft vessel 3210, incision seal
3230, support tube 3250, connector 3240, main vessel 3220, and incision
3290), which is referenced for purpose of providing examples and
like-named elements and varying descriptions may be found herein.

[0127] Here, method 3500 begins by cutting graft vessel 3210 at step 3502.
Graft vessel 3210 may be interchangeably referred to as a "first vessel,"
a "donor artery," or "other vessel." As an example, graft vessel 3210 may
be clamped at two points to stop the blood flow in a section of graft
vessel 3210. This may help minimize blood loss from graft vessel 3210
during the vascular anastomosis procedure. As another example, graft
vessel 3210 may be cut at an angle. The angle may be determined by the
junction between graft vessel 3210 and the wall of main vessel 3220 and
implemented at varying degrees (e.g., 15, 25, 35, 45, 90 degrees, or
others). This may minimize leakage from the junction between graft vessel
3210 and main vessel 3220 by allowing graft vessel 3210 to securely
contact the wall of main vessel 3220 at the junction. In other examples,
the angle may be substantially the same as the angle determined by the
plane of the end of support tube 3250 relative to the axis of the lumen
or by the angle created by the junction of the lumen and the base of the
incision seal. For example, the angle may be 10, 12, 27, 38, 45 or any
other angular degree measurement.

[0128] After cutting graft vessel 3210, a cut end of graft vessel 3210 is
pulled through incision seal 3230 at step 3504. In some examples,
incision seal 3230 may be implemented similarly or substantially similar
in function and structure as incision seal 3230 shown and described in
FIG. 34. As an example, graft vessel 3210 may be pulled through a lumen
of incision seal 3230 with the use of a precision grasping instrument. In
some examples, the precision grasping instrument may be a pair of pliers
or tweezers.

[0129] After pulling graft vessel 3210 though incision seal 3230, graft
vessel 3210 is subsequently pulled through support tube 3250 at step
3506. In some examples, support tube 3250 may be implemented similarly or
substantially similar in function and structure as the support tube shown
and described in FIG. 33. Similar to step 3504, a grasping instrument may
be used to pull graft vessel 3210 though support tube 3250.

[0130] After graft vessel 3210 is pulled through support tube 3250, the
cut end of graft vessel 3210 is folded over support tube 3250 at step
3508. Graft vessel 3210 may be folded over the outer surface of support
tube 3250 in preparation of securing graft vessel 3210 to connector 3240.
For example, folding graft vessel 3210 over the length of the outer
surface of support tube 3250 may apportion a segment (i.e. portion) of
graft vessel 3210 that may later be used to securely couple graft vessel
3210 to connector 3240. In some examples, graft vessel 3210 may be
oriented with respect to support tube 3250 before folding. For example,
an angled end of support tube 3250 may be aligned with the angle of the
cut end of graft vessel 3210 before folding. Properly orienting graft
vessel 3210 and support tube 3250 in this manner may assist in ensuring
that both the end of graft vessel 3210 and the end of support tube 3250
securely contact the wall of main vessel 3220 when graft vessel 3210 is
coupled to main vessel 3220. This may minimize leakage at the junction of
main vessel 3220 and graft vessel 3210. In some examples, a French
dilator may used during the folding of graft vessel 3210. For example,
the French dilator may be inserted into graft vessel 3210 before graft
vessel 3210 is folded over support tube 3250. This may provide a rigid
support inside graft vessel 3210, thus simplifying manipulation of the
position and orientation of graft vessel 3210. As an example, the French
dilator may assist in aligning graft vessel 3210 and support tube 3250.
In another example, the French dilator may assist in folding graft vessel
3210 over support tube 3250. The French dilator may be left within graft
vessel 3210 to maintain the configuration of graft vessel 3210 and
support tube 3250 until graft vessel 3210 is ready for use.

[0131] After graft vessel 3210 is folded over support tube 3250, incision
3290 is created on the wall of main vessel 3220 at step 3510. Incision
3290 may be created at a location where a surgeon wishes for graft vessel
3210 to couple with main vessel 3220. In some examples, incision 3290 may
be created by piercing the wall of main vessel 3220 with a needle. The
needle may comprise a hollow cylinder loaded with a guide wire configured
to assist the insertion of connector 3240 into main vessel 3220. As an
example, the needle may pierce the wall of main vessel 3220 at an angle
that minimizes the likelihood of accidentally piercing through the
opposite wall of main vessel 3220. The needle loaded with the guide wire
may be inserted into main vessel 3220 and then removed while leaving the
guide wire inside main vessel 3220. For example, the needle may pierce
the wall of main vessel 3220, enter main vessel 3220 with the guide wire,
and retract from main vessel 3220 leaving the guide wire inside main
vessel 3220. A portion of main vessel 3220 surrounding the needle entry
point may be clamped off prior to the incision. This may minimize the
blood loss during the procedure.

[0132] After creating incision 3290 in main vessel 3220, an introducer is
inserted into the incision at step 3512. The introducer may be configured
to prepare the incision for insertion of connector 3240. After preparing
the incision, a deployment tool may couple with the introducer and deploy
connector 3240 within main vessel 3220. In some examples, the introducer
may be threaded onto the guide wire and a tip of the introducer may be
inserted into the incision. A dilator may be coupled to the tip of the
introducer to ease the tip of the introducer inside main vessel 3220.
Once the tip of the introducer is inside main vessel 3220, the dilator
and the guide wire may be removed from main vessel 3220.

[0133] FIG. 36 illustrates an exemplary introducer. Introducer 3600 may be
configured to be inserted into an incision in a wall of a main vessel and
to guide a deployment tool inside the main vessel. In some examples, the
deployment tool may be implemented similarly or substantially similar in
function and structure as the syringe shown and described in FIG. 37
(discussed below). Here, introducer 3600 may include body 3610, locking
mechanism 3612, alignment mark 3614, and introducer tip 3620. Body 3610
may comprise a hollow chamber having a wide opening and a narrow opening
opposite of the wide opening. Body 3610 may be configured to receive a
deployment tool through the wide opening. A portion of the deployment
tool may be housed within the hollow chamber so that the two components
are securely coupled together. In some examples, the hollow chamber may
be of sufficient length such that when the portion of the deployment tool
is received, the deployment tool and introducer 3600 are securely
coupled. The narrow opening of body 3610 may be coupled to introducer tip
3620. Introducer tip 3620 may be a cylindrical tube configured to guide a
deployment tool through an incision along the wall of main vessel 3680.
In some examples, an end of the deployment tool may be located inside
main vessel 3680 when the deployment tool is inserted into body 3610.

[0134] Body 3610 may be further coupled to locking mechanism 3612. Locking
mechanism 3612 may be disposed along the wide opening of body 3610. In
some examples, locking mechanism 3612 may be configured to interlock with
the deployment tool. Once interlocked, the deployment tool and introducer
3600 may be securely coupled to one another. Thus, moving the deployment
tool may also move introducer 3600, and vice versa. As an example,
locking mechanism 3612 may be a male fitting or a female fitting of a
male-female interconnect pair. The counterpart of the male-female
interconnect pair may be disposed on the deployment tool. Thus, the
deployment tool may be interlocked with the introducer by pressing
together the male fitting and the female fitting and screwing together
the male-female interconnect pair. In some examples, the male fitting and
the female fitting may be tapered to minimize leakage of fluids traveling
through the fittings. As shown here, locking mechanism 3612 may be a male
luer lock fitting.

[0135] To ensure that introducer 3600 is properly connected to the
deployment tool, body 3610 may also include alignment mark 3614.
Alignment mark 3614 may be configured to align with another alignment
mark located on the deployment tool. As an example, alignment mark 3614
may align with alignment mark 3715 of deployment tool 3700 shown in FIG.
37 when the male fitting and female fitting are properly aligned to be
screwed together. This may provide a visual aid that introducer 3600 and
the deployment tool are ready to be connected. As another example,
alignment mark 3614 may align with alignment mark 3715 when the male
fitting is securely connected with the female fitting. This may provide
visual confirmation that the deployment tool and the introducer are
properly connected. In other examples, introducer 3600 may be made of
medical grade plastic materials, including Polyether ether ketone (PEEK).
In other examples, the above-described elements may be implemented
differently and are not limited to the examples shown and described.

[0136] Returning back to FIG. 35, a deployment tool is coupled to the
introducer after the introducer is inserted into the incision at step
3514. The deployment tool may be a syringe or other device configured to
deploy connector 3240. In some examples, the deployment tool may include
a fitting configured to join with another fitting disposed on the
introducer. When joined, the deployment tool and the introducer may be
securely connected to one another. As an example, a tip of the deployment
tool may be inserted into main vessel 3220 through a tip of the
introducer when the deployment tool and the introducer are securely
connected. In some examples, alignment marks are placed on both the
introducer and the deployment tool to ensure that the two tools are
properly connected.

[0137] FIG. 37 illustrates an exemplary syringe preloaded with a
connector. Syringe 3700 may be configured to couple with an introducer
and to deploy a connector inside a main vessel. In some examples, the
introducer may be implemented similarly or substantially similar in
function and structure as the introducer shown and described in FIG. 36.
Here, syringe 3700 may include body 3710, handle 3711, plunger 3712, rod
3714, locking mechanism 3716, deployment tip 3718, and connector 3720.
Syringe 3700 may be configured to deploy connector 3720 from deployment
tip 3718 when plunger 3712 is depressed. As shown here, connector 3720
may be pre-loaded within deployment tip 3718 to save valuable time during
surgery. In other examples, syringe 3700 may be reusable by loading
connector 3720 within deployment tip 3718 prior to surgery.

[0138] Body 3710 may comprise of a hollow chamber with handle 3711
disposed towards one end. As an example, the hollow chamber may be
configured to house plunger 3712. Plunger 3712 may be received through
one end of body 3710. In some examples, plunger 3712 may include a safety
pin (not shown) configured to prevent accidental deployment of connector
3720. For example, the safety pin may intersect plunger 3712 and contact
an edge of handle 3711 when syringe 3700 is not ready for use. This
configuration may prevent plunger 3712 from being depressed. The safety
pin may be removed from plunger 3712 when syringe 3700 is ready for use.
In some examples, body 3710 may comprise plastic, glass, or other
synthetic or natural materials.

[0139] Plunger 3712 may be coupled to rod 3714. As shown here, rod 3714
may include an end configured to couple with plunger 3712 and an opposite
end configured to deploy connector 3720. As an example, rod 3714 may push
connector 3720 through deployment tip 3718 when plunger 3712 is
depressed. Depressing plunger 3712 may push rod 3714 towards an end of
deployment tip 3718 which in turn may push connector 3720 out of the end
of deployment tip 3718. Thus, the rate of deployment of connector 3720
may depend upon the rate that plunger 3712 is depressed. As an example,
one end of rod 3714 may be approximately the same shape as an end of
plunger 2712. In another example, another end of rod 3714 may be
approximately the same diameter as deployment tip 3718.

[0140] As shown here, body 3710 may be coupled to locking mechanism 3716.
Locking mechanism 3716 may be configured to connect or interlock with an
introducer. In some examples, the introducer may be implemented similarly
or substantially similar in function and structure as the introducer
shown and described in FIG. 36. As an example, locking mechanism 3716 may
be a male fitting or a female fitting of a male-female interconnect pair.
The counterpart of the male-female interconnect pair may be disposed on
introducer 3600. This may allow introducer 3600 and syringe 3700 to
securely interlock with one another when the male-female interconnect
pair is threaded together. As shown here, locking mechanism 3716 may be a
female luer lock fitting. As an example, connector 3720 may be located
inside a main vessel when the introducer and syringe 3700 are securely
coupled. In some examples, the male-female interconnect pair may be
tapered to minimize leakage.

[0141] In some examples, locking mechanism 3716 may include an alignment
mark 3715. Alignment mark 3715 may be configured to ensure that syringe
3700 is properly connected with introducer 3600 before connector 3720 is
deployed. In some examples, a surgeon may infer information when
alignment mark 3715 is aligned with alignment mark 3614 of introducer
3600. As an example, alignment of the alignment marks may confirm that
the male-female interconnect pair are properly aligned to be screwed
together. In another example, alignment of the alignment marks may
confirm that the male-female interconnect pair are securely connected to
one another and therefore, connector 3720 may be deployed by depressing
plunger 3712. In yet other examples, the above-described elements may be
implemented differently and are not limited to the examples shown and
described.

[0142] Returning to FIG. 35, connector 3240 is deployed inside main vessel
3220 at step 3516. As an example, a plunger belonging to a deployment
tool (as shown in FIG. 37) may be depressed to deploy connector 3240. In
some examples, position of the deployment tool and the introducer may be
manipulated prior to deployment to ensure that connector 3240 is deployed
at the desired position inside main vessel 3220. For example, the
introducer may be pulled out of the incision while leaving a tip of the
deployment tool inside main vessel 3220. This may position the deployment
of connector 3240 in the center of main vessel 3220 or any other
desirable position for proper deployment of the wings and barbs belonging
to connector 3240 inside main vessel 3220.

[0143] After connector 3240 is deployed inside main vessel 3220, the
introducer (as shown in FIG. 36) and the deployment tool (as shown in
FIG. 37) are removed from the incision at step 3518. In some examples,
removing the deployment tool may deploy a portion of connector 3240
outside main vessel 3220. As an example, the portion of connector 3240
outside main vessel 3220 may include a suture thread. The suture thread
may be used to seat connector 3240 along the wall of main vessel 3220.

[0144] After removing the introducer and the deployment tool, the wall of
main vessel 3220 is pierced with a barb of connector 3240 at step 3520.
Piercing the wall of main vessel 3220 with the barb may allow the barb to
become accessible to incision seal 3230 located outside main vessel 3220.
In some examples, piercing the wall of main vessel 3220 with the barb may
include a two step process. In a first step, connector 3240 may be pulled
by a suture thread attached to connector 3240. This may position the barb
along the interior wall of main vessel 3220 and simplify the locating of
the barb from the exterior wall of main vessel 3220. In a second step, a
puncturing tool may be placed over the location of the barb to assist the
barb through the wall of main vessel 3220. As an example, the puncturing
tool may be a tube that is pressed firmly over the location of the barb
while connector 3240 is pulled by the suture thread. These opposing
forces may cause the barb to pierce through the wall of main vessel 3220.
If there are multiple barbs, the puncturing tool may be used multiple
times to pierce each barb through the wall of main vessel 3220.

[0145] After the barb of connector 3240 has pierced the wall of main
vessel 3220, graft vessel 3210 is securely coupled to connector 3240 at
step 3522. This may include orienting an edge of graft vessel 3210 to
main vessel 3220 and securely coupling graft vessel 3210 to connector
3240. As an example, a dilator may have been used to maintain the
configuration of graft vessel 3210 and support tube 3250 while main
vessel 3220 was being operated on. If a dilator was used, the dilator may
be removed before graft vessel 3210 is placed on top of connector 3240.
In some examples, graft vessel 3210 may be placed on an end of connector
3240 and the portion of graft vessel 3210 folded over support tube 3250
may be unrolled over connector 3240. Advantages of unrolling graft vessel
3210 over connector 3240 instead of pulling graft vessel 3210 over
connector 3240 may include minimizing traumatization to the interior wall
of graft vessel 3210. A handling tool may be used to unroll graft vessel
3210 from support tube 3250 onto connector 3240. Examples of handling
tools may include pliers, tweezers, or other precision grasping tools. In
some examples, the length of support tube 3250 may be proportionate to
the length of the portion of graft vessel used to securely couple with
connector 3240. Once graft vessel 3210 is unrolled over connector 3240,
support tube 3250 may slide down towards the junction between graft
vessel 3210 and main vessel 3220. As an example, a piece of graft vessel
3210 may be sandwiched between support tube 3250 and main vessel 3220.
This may provide a seal between the two vessels, thereby minimizing
leakage at the junction. In another example, support tube 3250 may
overlap the portion of connector 3240 contacting graft vessel 3210. The
overlap of support tube 3250 and connector 3240 may sandwich the end of
graft vessel 3210 in between support tube 3250 and connector 3240. This
may provide a restraining force to securely couple graft vessel 3210 to
connector 3240.

[0146] Once the graft vessel is attached to connector 3240, incision seal
3230 is securely coupled to connector 3240 at step 3524. In some
examples, incision seal 3230 may be slid down over support tube 3250 and
securely couple with one or more barbs of connector 3240 that are
protruding from the wall of the main vessel (i.e. protruding barbs). For
example, incision seal 3230 may receive the protruding barbs and secure
the protruding barbs inside incision seal 3230. As an example, the
protruding barbs may pierce through the surface of incision seal 3230 and
become lodged within incision seal 3230. Once lodged, incision seal 3230
and connector 3240 may provide a clamping force that couples the graft
vessel to main vessel 3220. The clamping force may also apply a constant
downward pressure on support tube 3250. The downward pressure may
minimize leakage from the junction by allowing support tube 3250 to
firmly press the graft vessel on the wall of main vessel 3220. The
downward force may also minimize the movement of the support tube after
the procedure is complete.

[0147] After incision seal 3230 is securely coupled to connector 3240, the
suture thread coupled to connector 3240 is removed at step 3526. As an
example, the suture thread may be cut and removed. After removal of the
suture thread, the clamps may be removed from the graft vessel and main
vessel 3220, thereby returning blood flow.

[0148] As set forth above, measurements, dimensions, or other
specifications may be varied and are not limited to those previously
described. Variations in sizes, shapes, and processes may also be
implemented and the above-described examples are also not intended to be
limiting.

[0149] The foregoing examples have been described in some detail for
purposes of clarity of understanding, but are not limited to the details
provided. There are many alternative ways and techniques for
implementation. The disclosed examples are illustrative and not
restrictive.